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A case of tertiary hyperparathyroidism with a parathyroid adenoma and hyperplasia was described as the first report in Japan. A 24-year-old man manifesting hypercalcemia had been treated with hemodialysis for 9 years. On admission, clubbed fingers richitic rosaries and a palpable node in the neck were the major physical findings. Laboratory examinations revealed hypercalcemia had elevated levels of plasma parathyroid hormone (PTH) in a c-terminal assay. Nevertheless the levels of PTH found by a n-terminal assay disclosed an only small increase. The PTH levels were scarcely decreased after a bolus injection of calcium gluconate. A large tumor corresponding to the palpable node was resected. Histologically, the tumor was an adenoma with thick fibrous capsule and interparenchymal bands. Other parathyroid glands showed secondary clear cell hyperplasia without signs of cellular hyperactivity.

We quantitatively assessed peripheral and autonomic nerve function in diabetic patients and compared them with various parameters of their diabetic status. Motor and sensory nerve conduction velocity (MCV, SCV), vibratory perception threshold (VPT) and the coefficient of variation of the ECG R-R interval (CV R-R) were measured in 85 diabetic patients aged 20-59 years. These values were compared with those of age-matched healthy subjects. Moreover, in 53 patients, MCV, SCV, VPT and CV R-R were investigated by multivariate analysis in relation to clinical parameters. In diabetics, MCV, SCV and CV R-R were significantly lower and VPT was higher than in age-matched healthy controls. The prevalence of impaired values in diabetics was 70% for VPT in the toe, 60% for SCV, and 55% for MCV, CV R-R and VPT in the finger. Impairments of MCV, SCV, CV R-R and VPT were closely correlated with diabetic retinopathy, proteinuria and duration of disease. Categorical regression analysis (multivariate analysis) revealed that the impairment of conduction velocity was closely related to diabetic retinopathy and to hypo- or areflexia, that the impairment of the vibratory perception threshold was related to ischemic changes in ECG and to hypo- or areflexia, and that the reduction of CV R-R was related to orthostatic hypotension and to proteinuria. These findings suggest that diabetic neuropathy progresses in parallel with other complications, and that it is a heterogeneous syndrome rather than a single entity.

To evaluate the function of the central nervous system of patients with occupational vibration disease, electroencephalograms and auditory brainstem responses (ABR) were recorded in 20 male subjects with occupational vibration disease whose age ranged from 46 to 67 years (mean 57.4 yr). All the subjects had operated chain saws from 10 to 25 yr (mean 15.2 yr) and had frequently complained of many subjective symptoms induced by central nervous system disturbances such as headache, head heaviness, tinnitus, vertigo, and insomnia, which corresponded to stage 3 in the diagnostic criteria of Andreeva-Galanina. Twenty-six healthy men whose age ranged from 40 to 67 yr (mean 53.0 yr) were selected as controls. Electroencephalograms were recorded with a 12-channel electroencephalograph, using unipolar and bipolar leads. Auditory brainstem responses were recorded by signal averaging technique using 100 microseconds alternating clicks. The stimuli were presented at 70 dB above threshold (SL) with a rate of 10 per second. The following results were obtained. 1. By electroencephalography, the incidence of diffuse alpha pattern, slow alpha wave and drowsy pattern was 32%, 32%, and 42%, respectively. 2. Click thresholds in the patients were obviously higher than those in the healthy controls. 3. The occurrence rate of wave II of ABR in the patients (61.8%) was significantly lower than that in the healthy controls (85.0%) (p less than 0.05). 4. The interpeak latencies I-V and III-V of ABR in the patients were significantly longer than those in the healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

The active component in crude ribosomal fraction (CRF) of Salmonella typhimurium, capable of inducing protective antibody, was partially purified by two series of chromatography (Sephadex G-150 and DEAE-Sepharose CL6B) after sodium dodecyl sulphate (SDS)-treated CRF was precipitated with ammonium sulphate. The major active component was eluted by 0.4-0.45 M NaCl from DEAE-Sepharose CL6B, and its molecular weight was 43,000 as determined by SDS-polyacrylamide gel electrophoresis. Immunization with the fraction containing 43,000 component alone did not always confer protection on CF1 mice, but its administration together with either the purified transfer RNA (tRNA) or Freund's complete adjuvant (FCA) was much more effective against infection with S. typhimurium. Antibody to the fraction containing 43,000 component was not only free in serum but also associated with peritoneal cells. Macrophages that had been exposed to the antibody had enhanced anti-bacterial activity. Western blot analysis showed that 43,000 component did not react to antiserum to lipopolysaccharide (LPS), but to antiserum to CRF. The antibody elicited by non-O antigenic component and the cell-mediated resistance stimulated by the adjuvant effect of RNA together confer effective protection on CF1 mice.

In order to compare the potential of salmonella vaccines prepared from Salmonella typhimurium to provide the longer-lasting protection from the aspects of cell-mediated immunity, groups of mice were immunized with optimal doses of the following preparations: live cells, ribosome-rich extract, acetone-killed cells, and heat-killed cells. At various intervals post-immunization, mouse peritoneal macrophages and splenic T cells were tested for biological activities. The capacity of each vaccine to confer mouse protection against a lethal challenge with S. typhimurium correlated with the degree of macrophage activation engendered by each of them in the early stage of immunization. In the late stage of immunization, the level of mouse protection conferred by each vaccine was found to be based on the capacity of T cells to respond to salmonella antigens, which correlated with the degree of adoptive immunity by T cells. The live-cell and ribosomal vaccines were superior to killed-cell vaccines in inducing the cell-mediated protection. Thus, the longer-lasting immunity provided by the live-cell and ribosomal vaccines can be accounted for by the fact that T cells of mice immunized with both vaccines have the persistent reactivity to salmonella antigens.

In order to evaluate the functions of the peripheral somatic nerve and autonomic nerve in patients with occupational vibration disease objectively and quantitatively, four examinations were performed on twenty 44-63 yr old patients with occupational vibration disease and their total operating time ranged from 5,000 to 43,750 h. 1) Motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) of the ulnar and median nerves were measured using conventional methods. 2) Electrogustatory thresholds under the controlled area of the chorda tympani nerve were measured by Tomita's method using an electrogustometer (610-M, M.E.C.). 3) Dopamine-beta-hydroxylase (DBH) activity in blood was assayed by the photometric assay of Nagatsu and Udenfriend. 4) Coefficient of variation of R-R interval in ECG (CVR-R) was measured after 15-min-resting in supine position by using a R-R interval analyzer (Autonomic R 100, M.E.C.). The results of these examinations were compared with those of special examinations for the diagnosis of vibration disease. In patients with occupational vibration disease, MCV and SCV of the ulnar and median nerve were lower in value than those in age-matched healthy controls. In particular, MCV of the ulnar nerve, MCV and SCV of the median nerve were significantly lower in the patients than in the controls. Nerve conduction velocities were significantly correlated with skin temperature and nailpress test, though diminished nerve conduction velocities observed in vibration disease patients were considered to be attributable to peripheral circulatory disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)